He built his asylum on the grounds of his family's mansion on the outskirts of Gotham City, and personally treated its first patient, Martin Hawkins, who had previously murdered his wife and daughter. Initially, Amadeus devoted himself to curing Hawkins, viewing it as his duty, but he eventually succumbed to his desire for vengeance.

After administering fatal electro-shock treatments to Hawkins, Amadeus completely lost his grip on sanity, and was admitted to his own institution.